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DOT & MC APPLICATION
First name
*
Last name
*
Email
*
Phone (Warning: They will solicit your lines. Use another phone number if you have one)
*
Role In Company
Owner
Manager
Company Contact
Mailing Address
Mailing Address
Country/Region
*
Address
*
City
*
Zip / Postal code
*
Business Name
*
Business Entity
*
LLC
INC
Corp
Employer Identification Number (EIN)
*
Business Address
Mailing Address
Country/Region
*
Address
*
City
*
Zip / Postal code
*
If applying for MC Authority
Will you be operating as an intermodal? (Intermodal is work at the port, hauling chassis)
*
Yes
No
What kind of property will you be hauling?
*
Hazardous Property
Household Goods
Exempt Commodities
General Freight
Do you transport your own property? (if you are working with dispatch/loadboards the answer is no, you transport OTHERS property)
*
Yes
No
Do you provide broker services?
*
Yes
No
Are you a freight forwarder?
*
Yes
No
Do you transport passengers?
*
Yes
No
Other
Towaway/Driveway
*
Yes
No
What kind of freight will you be hauling?
*
Dy goods
Refrigerated goods
Household goods
Metal
Motor vehicles
Lumber
Driveway/Towaway
Building materials
Mobile homes
Machinery
Liquids
Intermodal
Passengers
Oil field equipment
Livestock
Grain
Coal
Meat
US Mail
Vehicle Information
Type of Truck
*
Box Truck
Tractor
Dump Truck
Tow Truck
Hot-Shot
How many truck/trucks?
*
Do you have any trailers? If so, how many
*
Are they leased or owned ?
*
Leased
Owned
Will you be operating in Canada or Mexico?
*
Yes
No
How many drivers do you have?Short answer
*
Have you ever been issued a USDOT Number before?
*
Yes
No
If yes, provide your previous DOT number:
*
Submit
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